Ky L DO, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41399 Issued in CA

Practice address

12072 Valley Blvd
El Monte, CA 91732-3137

Phone

(626) 527-2200

Fax

(626) 527-2205

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Dental Group

  • General Practice Dentistry
  • El Monte, CA
  • NPI 1366510901
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1255428058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12072 VALLEY BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323137",
            "telephone_number": "626-527-2200",
            "fax_number": "626-527-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12072 VALLEY BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323137",
            "telephone_number": "626-527-2200",
            "fax_number": "626-527-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "KY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "900200438",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dilip G. Patel MD Inc
• Cristy Dimaya, RN
• Christine Thu DO, DO
• Karen DO
• Kimchi T DO, DDS
• Doctors & Associates Medical Group Inc. a Professional Corporation
• Doctors of Southern California
• Doctors of Southern California
• Rocio Dominguez
• Steven Dominguez

• General Practice Dentistry in El Monte, CA
• Providers in El Monte, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.